How much rates vary
Facilitymedian $1,175 · 10th to 90th $513 to $8,913Professionalmedian $1,514 · 10th to 90th $1,023 to $2,512
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,047.13 Median $7,079.46 Typical High $12,302.69 | Facility | None | $1,047.13 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $2,951.21 | Professional | None | $1,047.13 | $1,047.13 | $2,951.21 |
Ambetter Setting Professional Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $10,715.19 | Facility | None | $724.44 | $2,187.76 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,513.56 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,238.72 Typical High $3,548.13 | Professional | 50 · Both sides | $1,621.81 | $2,238.72 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $954.99 Typical High $1,479.11 | Professional | 62 · Two surgeons | $676.08 | $954.99 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $245.47 Typical High $380.19 | Professional | 80 · Assistant surgeon | $173.78 | $245.47 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $208.93 Typical High $331.13 | Professional | AS · PA/NP assist | $151.36 | $208.93 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,230.27 | $1,778.28 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,258.93 | $2,238.72 |
Oscar Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,096.48 | $1,584.89 | $2,818.38 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $239.88 | Professional | 53 · Discontinued | $208.93 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $891.25 | Professional | 54 · Surgery only | $794.33 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $831.76 |
Where Georgia sits
The same service costs 16.4 times more in Maine than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $28,429MD $1,737
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.